Nursing informatics

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Nursing informatics is a specialty that "integrates nursing science with multiple information and analytical sciences to identify, define, manage and communicate data, information, knowledge, and wisdom in nursing practice" [1]. Nursing informaticist typically have a strong nursing background in addition to informatics training and therefore can facilitate the implementation of user friendly and practical solutions to staff [2]. Based on the 2017 HIMSS survey, 40% of participants reported system implementation was a responsibility followed by other areas, including quality initiatives and project management [3]. Many hospitals now employ Chief Nursing Information Officers (CNIO) to help guide policies and implement new technologies.


History

A 2009 HIMSS survey on the impact of informatics nurses shows that nursing informatics is involved in a variety of roles related to information technology. This includes workflow analysis, education, HIT implementation and support. On a 1-7 point scale, with 7 being the highest, survey respondents rated the value of nursing informatics an average 6.29 This value is seen in patient safety, workflow, facilitating user acceptance and change management [4].

In the last few years, hospitals have been shifting their focus from operations to outcomes. This shift translates into reimbursement. Leveraging information technology (IT) will facilitate this process. IT can be used in the collection of data to determine which quality outcomes an organization should emphasize. Nursing informaticists play a role in the collection and interpretation of this data [5].

With the focus of the American Recovery and Reinvestment Act on electronic health records and financial incentive, the role of nursing informatics is becoming more important. Meaningful use criteria must be met by 2015 in order to receive full reimbursement. Nursing informaticists can help organizations achieve this goal. Their knowledge on the integration of evidence-based knowledge and information systems that promote patient safety and quality outcomes is essential to meet meaningful use [6].

With the advent of the full implementation of the Affordable Care Act in 2014, an estimated 30 million new patients will be insured and demand care. The 3 million nurses currently practicing in the U.S. are expected to provide better quality, safer care to a larger number of people in a health care environment that is rapidly changing. The proficient use of technology is thought to facilitate the fulfillment of this enormous challenge.

American Nursing Informatics Association (ANIA)

ANIA is an organziation involving roughly 3000 informaticists in nursing and other fields.

ANIA Mission: To advance nursing informatics through education, research, and practice in all roles and settings.

ANIA Vision: To be the organization of choice to advance nursing informatics.

Originally, ANIA was founded in 1982 by Capital Area Roundtable on Informatics in Nursing (CARING). This undertaking started as a forum for nurses striving to advance automated healthcare systems [7].

ANIA was formed in 1992 as a means for "networking, education, and information resources" to facilitate the role of nurses in informatics [7]. Starting in 2005, ANIA and CARING initiated a merger and held their first official joint conference in 2007. These groups officially merged in 2010.

Information regarding members, joining the organization, goals, and conferences can be found on the ANIA fact sheet.

Alliance for Nursing Informatics

The Alliance for Nursing Informatics (ANI) is a group of organizations that represent more than 20,000 nursing informaticists. ANI is cosponsored by two other large informatics entities, AMIA and HIMSS. ANI "advances nursing informatics leadership, practice, education, policy and research through a unified voice of nursing informatics organizations. We transform health and healthcare through nursing informatics and innovation" [8].

Technology Informatics Guiding Education Reform (TIGER)

The Technology Informatics Guiding Education Reform (TIGER) Initiative was formed in response to the 2004 creation of the Office of the National Coordinator (ONC) for Health Information Technology [9]. A summit with nursing stakeholders took place in 2006 to ensure the nursing workforce were capable of using IT to improve the delivery of care [9]. This group, funded by the Robert Wood Johnson Foundation and supported by many organizations to " engage and prepare the nursing workforce in using technology and informatics to improve the delivery of patient care" [9]. The TIGER Informatics Competencies Collaboritive (TICC) formed in 2010 and later released the document, Informatics Competencies for Every Practicing Nurse: Recommendations from the TIGER Collaborative [10]. The complete list of competencies can be found in the following document.

As of September 22, 2014, TIGER joined HIMSS and adopted a more interprofessional and interdisciplinary approach [11]. This transition has facilitated international collaboration -- an in-depth review of its current state can be found in the document here.

Nursing Education

Given the ever expanding role of computers and information technology in medicine, it is paramount that nurses receive sufficient education to interact with multiple systems as well as enter and extract data [12]. Studies have indicated that nurses will need to think critically and exercise clinical decision to meet the demands of the evolving technological environment [12]. Furthermore, while there is the assumption that millennial students are skilled in technology, students entering nursing programs today are a "mixed body of traditional and non-traditional students who are widely varied in their informatics competency and are most likely deficient in most aspects of informatics" [12]. Nurses may obtain certifications, a masters degree, and doctorate in nursing informatics, which opens up a variety of informatics careers.

Nursing Certification and Renewal Process

Nurses interested in pursuing a career in Nursing Informatics can obtain an official certification. This consists of meeting criteria to sit for a board examination that is maintained through the American Nursing Credentialing Center (ANCC). Upon successful completion of the examination, nurses gain the title of an RN-BC. Eligibility for this exam includes the following:

Eligibility [13]

  • Hold a current, active RN license in a state or territory of the United States or hold the professional, legally recognized equivalent in another country.
  • Hold a bachelor's or higher degree in nursing or a bachelor's degree in a relevant field.
  • Have practiced the equivalent of 2 years full-time as a registered nurse.
  • Have completed 30 hours of continuing education in informatics nursing within the last 3 years.
  • Meet one of the following practice hour requirements:
    1. Have practiced a minimum of 2,000 hours in informatics nursing within the last 3 years;
    2. or

    3. Have practiced a minimum of 1,000 hours in informatics nursing in the last 3 years and completed a minimum of 12 semester hours of academic credit in informatics courses that are part of a graduate-level informatics nursing program;
    4. or

    5. Have completed a graduate program in informatics nursing containing a minimum of 200 hours of faculty-supervised practicum in informatics nursing.

Nurses who are certified in Informatics are required to renew their license every 5 years.This process can be found on the ANCC website under renewals.

Future of Nursing Informatics

Nursing informaticists will need to continue to develop skills to adapt to the ever expanding medical field. Nurses will need to be familiar with[1]:

  • Expansion into less traditional settings, such as long-term care and rural communities
  • ACOs, home health, and interprofessional teams
  • Personal health records and helping patients with these new technologies
  • Clinical data repositories and information exchanges to support transfer of patient data across various healthcare settings.

According to the American Nurses Association, key concepts to understand in this landscape involve preparing for technological innovations, designing and implementing new information technologies, evidence-based practice, telehealth, promoting usable technology (human-computer interaction), and both public and private initiatives for disease trends [1]

References

  1. 1.0 1.1 1.2 American Nurses Association. (2015). Scope and Standards of Practice: Nursing Informatics. Silver Spring, MD. American Nurses Association.
  2. All Nursing Schools. Nursing Informatics Specialist Job Description & Career Outlook. Retrieved October 14, 2019 from https://www.allnursingschools.com/nursing-informatics/job-description/#targetText=Nursing%20Informatics%3A%20Using%20Data%20to,of%20data%20and%20technical%20systems.&targetText=Some%20common%20titles%20in%20nursing,Nurse%20informaticist.
  3. HIMSS 2017 Nursing Informatics Workforce Survey. (2017). Retrieved from: https://www.himss.org/sites/himssorg/files/2017-nursing-informatics-workforce-full-report.pdf 2017 HIMSS survey.
  4. Healthcare Informatics and Management Systems Society. (2009, April 2). HIMSS 2009 Informatics nurse impact survey (Executive Summary). Retrieved from HIMSS website: http://www.himss.org/content/files/HIMSS2009InformaticsNurseImpactSurvey.pdf
  5. Murphy, J. (2010, August). The journey to meaningful use of electronic health records. Nursing Economics, 28, 283-286.
  6. Sensmeier, J. (2009, September). The latest? A shift from operations to outcomes. Nursing Management, 2-9.
  7. 7.0 7.1 ANIA. About Us. (2019). Retrieved Octoboer 19, 2019 from: https://www.ania.org/about-us.
  8. Allicance for Nursing Informatics. (2019). Retrieved October 19, 2019 from https://www.allianceni.org/.
  9. 9.0 9.1 9.2 Technology Informatics Guiding Education Reform. (2017) History of the TIGER Initiative. Retrieved October 19, 2019 from: https://www.himss.org/sites/himssorg/files/TIGER%20History%202017.pdf
  10. Healthcare Information and Management Systems Society (HIMSS) (2017).The Evolution of TIGER Competencies and Informatics Resources. Retrieved from: https://www.himss.org/library/evolution-tiger-competencies-and-informatics-resources
  11. Healthcare Information and Management Systems Society (HIMSS). Retrieved October 19, 2019 from https://www.himss.org/professionaldevelopment/tiger-initiative
  12. 12.0 12.1 12.2 Foster, M and Sethares, K. (2017) Current Strategies to Implement Informatics into the Nursing Curriculum: An Integrative Review. Retrieved from: https://www.himss.org/library/current-strategies-implement-informatics-nursing-curriculum-integrative-review
  13. American Nursing Credentialing Center. (2019). Informatics Nursing Certification (RN-BC). Retrieved from https://www.nursingworld.org/our-certifications/informatics-nurse/

Submitted by Matthew Cain. History section previously submitted by Kathy Gaines and Michelle Tellez.